Monday, August 24, 2009

Health Care on Life Support

As progressives have watched in horror and disbelief—can it be possible that the same right-wing fools who gave us Bush/Cheney, the war in Iraq, and its related bag of lies, fraud, raiding of the public treasury and outright criminality, have regained the initiative?—the alleged movement for health care reform has been chopped to pieces and is now threatening to collapse altogether into some fraud tailored to the specifications of big Pharma and big Healthcare. Sarah Palin has accused the new Democratic proposals of providing “death panels” to threaten the life of her Down’s syndrome child (has there ever been so shameless a public figure, willing to use her handicapped child to score political points?), while health care companies like United Health have urged their employees to mob the Democrats’ vaunted town hall meetings and shout them down with their slogans. To top it off, several of these yahoos have shown up at town meetings packing guns—one yo-yo at a recent Obama event with an assault rifle slung over his shoulder was featured in every newscast.
            The coup de grace came this week, with both Obama himself and Health and Human Services Secretary Kathleen Sebelius saying that the “public option” wasn’t really essential to health care reform, and that co-ops could be a way to go. This was mightily pleasing to both Republicans and that “key” senator from the crucial state of North Dakota, Kent Conrad, who characterized co-ops as a workable compromise that could pass the Senate.
            In the midst of the sinking feeling that whatever does emerge as health care reform will be so gutted as to be meaningless (or worse: it turns out that Obama has already made a deal with big Pharma that his health care plan won’t, repeat WILL NOT use the government’s bargaining power to get lower prices for drugs!), two recent proposals seem worth considering.  One was posted by Thom Hartmann on Common Dreams August 17. In the form of a letter, it suggested to the president that a simple solution would be: let all who choose to buy into Medicare. No new program to invent. No nonsense about forcing people into something they don’t like. Simply amend Medicare so that
“any American citizen can buy into the Medicare program at a rate to be set by the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services (HHS), which reflects the actual cost for us to buy into it….To make it available to people of low income, raise the rates slightly for all currently non-eligible people under 65, to cover the cost of below-200%-of-poverty people. Revenue neutral.” 
Seems like a plan to me. Nearly everyone who has Medicare seems to be quite satisfied with it (even the morons who have been ranting at town-hall meetings that they’re dead set against government-controlled health care, most of whom actually have Medicare!). Hartmann’s point is, why limit it to just people over 65? Let everyone buy in, pay for their own coverage until they reach 65, and thus cover everyone who’s dissatisfied with the Health-Care pirates.
            The other is a brilliant piece by renowned linguist and activist George Lakoff, who analyzed what’s wrong with the Obama approach so far. In a piece titled “The PolicySpeak Disaster for Health Care,” (, 8/20/09), Lakoff points out what he’s been trying to drum into Democrats for years, the importance of “framing.” The Republicans, by imitating marketing techniques, have long since mastered this stuff. The Democrats seem to think it’s manipulating the public and try, instead, to employ Policy Speak to appeal to the public’s reason. According to Lakoff, this is based in 17th century views that “if you just tell people the policy facts, they will reason to the right conclusion and support the policy.” In other words, rational discussion and logic will persuade people of the rightness of liberal democratic principles. WRONG. As Lakoff points out, even though 80% of the public wants a public plan, calling it the “public option” is a disaster. As cognitive neuroscientists have discovered—and marketers and Republicans, unlike Democrats, have taken into account—you have to appeal to people as they really think, in a way that resonates with them, and inspires them to act. Emotions are a big part of this, and emotions as well as the moral sense must be appealed to (Republicans appeal to emotions in the most calculating, irrational, and truly nefarious ways: “death tax,” “death panels,” “socialized medicine,” even Obama with a Hitler mustache—at the same time he’s accused of being a Commie).
            Accordingly, Lakoff suggests a simple narrative, using a simple patriotic title: The American Plan. It would tell the truth, but tell it simply, without fear of appealing to morality:
            “Insurance company plans have failed to care for our people. They profit from denying care. Americans care about one another. An American plan is both the moral and practical alternative to provide care for our people.
            “The insurance companies are doing their worst, spreading lies in an attempt to maintain their profits and keep Americans from getting the care they so desperately need. You, our citizens, must be the heroes. Stand up, and speak up, for an American plan.”
Lakoff also suggests using other simple, but emotional/moral language and slogans instead of boring “policy speak”: Doctor-patient care; Coverage is not Care; Insurance Company profit-based plans ration care; Doctors care, insurance companies don’t; and so on.
            Lakoff also punctures the simple-minded Democrat attempt to avoid the dreaded accusation, “culture wars.” As he notes, the culture war is already on and can’t be ignored. Call the villains and liars out, in public. The president has the biggest bully pulpit in the land. He has to start using it, instead of continuing to make a vain attempt to achieve some longed-for spirit of bipartisanship. He needs to demonstrate some passion, if for no other reason than to counter the evil passions being stirred up by his opponents, and that includes so-called moderates like Senator Chuck Grassley. Grassley displayed no reluctance at all to suggest, on the Newshour recently, that Obama’s plan was a government takeover of all health care and equivalent to socialism. There’s no way to make nice or use logic with such people. Use the power of the presidency, and the power of the Democratic majority, letting the Republicans know that if they wish to come along, fine, but if not, they will be accused of placing their corporate constituents ahead of the majority’s welfare.
            I would also add that it’s time the administration started to play hardball with the so-called Blue Dog Democrats. Why should these refugees from conservative districts, along with a few white-bread legislators from small-population states like Montana and North Dakota, shape and control the most important legislation of our time? Every Democrat should know that a “public option” (finding another name for it) is critical, that it must be included in any bill that the president will sign, and that failure to support it will be dealt with by means of all the patronage tactics available to the party’s leadership.
            Short of these course corrections—and it’s not too late, though the fight now, if Obama has the political and moral courage to engage it, will be long and dirty—the signature initiative of the Obama presidency will go down in flames. With it will go the hopes that the United States might be saved from the military/corporate/privatizing corruption that has engulfed it these last thirty years.
Lawrence DiStasi

Friday, August 14, 2009

The Deep Beauty of Conspiracy Theorists

Just how wrong are you now
If you don’t see that cow
That used no steroids or spoon
And leaped joyfully over the moon?
If I lie and you swear it is so
Then where do we go
On our journey to fashion a tale
Of intrigue and sinister woe
When breaths become gales
And minnows are whales
Then just where do we go?

For the past decade or so, it has been fashionable to equate one opinion to another, even when an “opinion” is unsupported with facts. FOX news has made a business out of reporting rumor and then commenting and operating on the assumption that a rumor, or worse, a lie, is true and worthy of further coverage. If we take the “birthers” for example, FOX and now CNN, through Lou Dobbs have extended the life and the strength of the false accusation that Mr. Obama is not a natural born US citizen. True, even Lou Dobbs does not directly say that Obama was not born in Hawaii, but he gives credence to the lie by constant repetition and by asking for proof that has already been provided. More recently, the “deathers” have pumped up the volume, even after being alerted that their statements are false.

Very recently, as congress members and senators have hit the trail to discuss the need for changes in our healthcare system, they have been systematically attacked by shout-down tactics that eerily remind me of the bullying by Stalinists in their early rise to power. Regardless of their heart felt conviction in their cause, their tactics are unconscionable. Instead of soliciting and enabling discussion, the process inculcates fear and shuts down discussion before it can begin. Recent revelations indicate that professional lobbyists have had their fine fingers on the puppet strings of many meetings that have issued “guidelines” to shut down meetings by filling rooms quickly to shout down and to stop politicians from speaking. In addition to being rude, the tactics do not bode well for an improved outcome for the healthcare programs we are trying to improve. Another approach is the old fashioned big lie. One specific example of using a known untruth is the introduction by Sarah Palin of “Death Panels” in the White House proposals. There are no “Death Panels.” Republican Senator Johnny Isakson proposed that there be a provision for end of life counseling that would help the elderly get living wills and similar advice to ease their minds and would help them make care decisions while they were able to do so. While the Palin accusations may sound ludicrous, she has defended her statements by saying that it could happen. So could “free bubble up and rainbow stew,” but making a campaign of either event is suspect and it panders to the lesser side of constituents. And, yes, Palin is campaigning despite quitting her job as governor with half her time to go. She only attacks Obama and not Isakson, so her motive seems more clear than her specific accusation. If you cannot see the conspiracy, then you are simply not looking for it. It must be there…somewhere.

Both the above tactics are simple and as old as politics itself. The elegance of simplicity, however, is overwhelmed by the negative purpose and outcome. This approach confuses and angers people, but will not add much in the way of alternative proposals for healthcare. Of course, there is also a simple elegance in the use of conspiracy theories by politicians and, in fact, any of us. It is impossible to prove a conspiracy theory to be wrong. No matter how much evidence you pile up, the conspiracy theory lives and even thrives. Hawaii has twice published the true extracts of the Obama birth certificates…doing it the second time to dispel the rumors and false statements by Rush Limbaugh and FOX News as well as others who simply want to keep the myth alive. People who insist that the earth is 6,000 years old and scoff at carbon dating and tons of evidence of early life on earth going back millions of years love conspiracies. Conspiracies explain faith. Conspiracies define enemies. Conspiracies define evil in the world. Unfortunately, they also define the holders of the “conspiracies.”

We need to look at the motivations of those who espouse and spread the conspiracies in order to expose them for the frauds that they are. Take, for example, Betsy McCaughey (pronounced McCoy) who has spread outright lies about the living wills recommended for the healthcare legislation. She is a lobbyist for healthcare insurers who want no limitations on their power to provide or deny coverage or charge rates that provide excess profits. Betsy is a member of the Hudson Institute. This is a group of neocons that helped bring you the war in Iraq. If you liked Iraq, you will love Betsy. She has twisted the provision to allow voluntary counseling to create living wills into a mandatory program for seniors to get death counseling to choose a poison or other means for euthanasia. It is not only dishonest, but is being used to scare the hell out of seniors. Others in this sinful cabal include Rush Limbaugh and Newt Gingrich. They are spreading misinformation and doing the bidding of “Freedom Works” headed by Dick Armey. That catchy name is a cover for privatizing Social Security (can you imagine the disaster had that been made law in today’s economic supply side disaster?); also to limit tort liability; to expand school vouchers and otherwise solidify the position of the rich as a permanent and deserving arrangement. In fact, supply side member Jack Kemp hailed the Katrina disaster as an opportunity to make the new economic order permanent. That alone makes the disaster seem caused by deliberate action instead of sheer incompetence. The connections of “Freedomworks” are prolific and include DLA Piper (an international lobbying and law firm) that lobbies for Bristol-Myers Squibb, for example.

If my information sounds like a special conspiracy, I apologize. It is the reality of big bucks calling the tune and FOX and the bobbleheads doing the dance. “Freedomworks” is a Republican pressure group that sends “aggressive” and “disgruntled” healthcare activists to disrupt meetings held by congressional advocates for change in the healthcare system. DLA Piper also employs Dick Armey and, surprisingly, Bristol-Myers Squib stands to lose about $400 Million if it has to negotiate drug prices due to new legislation. Imagine that! The gravy train established by the Bush policy of forbidding drug price negotiation might slosh to a halt. Unforgivable. If you find that my brief research is too bizarre to be accepted, then do your own, but do not accept the claim that these are simply unguided and spontaneous (rude) people expressing themselves in open forums. They have scripts and follow them. The scripts are provided by major lobbies and the Republican party.

Now why would all these folks spend this time, money and energy to kill improvements to healthcare? Their reasons are really simple. Large companies providing drugs or insurance want to dictate terms to maximize profits. Nothing is new there. Politicians on the right also need to prevent changes in healthcare to protect their major donors and to remain relevant in politics. Can you imagine what would happen if Obama succeeds? There would be no place for right-wingers at the money trough and they would have to say something other than “no” and that would mean learning a vocabulary beyond obstruction. Incidentally, they also have a lot invested in stopping the economic recovery for similar reasons. If the recovery plan works, the curtain is drawn open for everybody to see the Wizard of Oz and he is not very pretty. We are seeing some whoppers in print and on the cable news sources, but the whoppers are only red herring minnows that distract us from the goal of improving healthcare and our economy. Set the hook and don’t make this a catch and release program. Make them accountable for engaging in a program of outright lies by calling them on each one and exposing their connections to the lobbies that bought them.

George Giacoppe
15 August 2009

Monday, August 03, 2009

Why Lobbyists Love Health Care Reform

The more we learn about the Democrats’ plan for health care, the more it seems that, though it might help to cover more people—which would be good—it really won’t address the underlying problem. That problem is simply put: as long as health care is a multi-billion dollar industry run not to care for people but to make huge profits, the profit makers will find ways to continue to drive themselves into profit Valhalla, and the public into sickness and ruin.
            As confirmation, we have a recent report, by the Associated Press no less, informing us why there will indeed be a health care bill this year, even though the industry, and their Republican  (and Democratic) stooges would prefer to keep things as they are. The report—“Lobbyists the silver lining in health care storm?” by Ricardo Alonso-Zaldivar—tells us why “the drug industry, the American Medical Association, hospital groups and the insurance lobby are all saying Congress must make major changes this year.” What? THEY want health care reform? How could this be?
            The answer is elementary. First, they see the writing on the wall: Joe Sixpack can’t afford health care any more. Second, government programs have “gotten increasingly friendly to private insurance companies,” giving them “major roles as middlemen” in Medicare and Medicaid. You know, like Bush’s great prescription-drug boondoggle for Medicare, called, cynically, Medicare Advantage.
            But the real bonanza for these guys is the central requirement, in both House and Senate plans, to require health care for all. That is, the new plan will require everybody to buy coverage. And what will this do? Why it will “guarantee a steady stream of customers subsidized by taxpayers not only for insurers, but for all medical providers.” In other words, 47 million more customers will now have to procure health insurance. And if they can’t afford it—otherwise, why wouldn’t they have it in the first place—good old Uncle Sam, which is the taxpayer, will help them to pay for it. No matter how high the costs go.
            Dr. Marcia Angell, who was a guest on Bill Moyers’ show last Friday, said essentially the same thing. Unless, she said, there’s a change in the system—the economic system of unfettered capitalism willing to sacrifice anyone and everything for profit—all President Obama’s health care reform will do is increase the profits for private health care companies, doctors, and hospitals by presenting them with a CAPTIVE MARKET—i.e., of Americans now FORCED to buy health care.
            The thing is, we already know how this turns out. Massachusetts and a half dozen other states have already enacted this kind of reform, giving subsidies to the poor in order for them to buy insurance from the private health industry. And it has turned out to be more expensive, not less. So it appears that the only way our obscene medical costs will ever be reduced is by means of a government-run plan (the so-called “public option” the Republicans have tried to characterize as, ugh, socialism!), or, even better, a single-payer plan like Medicare. It would be a real plan that, by virtue of the numbers enrolled and the government’s power of mass purchasing, for instance from drug companies, but also from doctors and hospitals, would be able to reverse the trend of ever more expensive treatments for the ever more numerous conditions the industry can soak us for. Without that—and it is not clear at this moment if a “public option” will survive the congressional bartering and lobbying process—the sharks will remain in business, with the predators growing ever fatter, and thus ever more able to bludgeon our so-called representatives in our so-called representative democracy (and I include the President himself) into doing their multibillion-dollar bidding.
            Lawrence DiStasi